Morphine Addiction

More people in the United States are addicted to opioids than ever. According to statistics published by the Substance Abuse and Mental Health Services Administration, U.S. admission rates for opioids aside from heroin skyrocketed 414 percent between 1997 and 2007, from about seven addicted people in 100,000 to 36 people per 100,000.

According to the International Narcotics Control Board, drug manufacturers made 416 tons of morphine in 2010. That year, the United States, along with Australia, Canada, Japan, New Zealand and a few European countries consumed more than 93 percent of those 416 tons.

Millions of Americans misuse these powerful pain relievers non-medically, either to get high or to treat an illness for which the medicine was not prescribed. Between the years 1992 and 2003, misuse of opioids rose 140 percent. In 2010, about one in 20 Americans over the age of 12 used prescription painkillers for non-medical purposes.

This high rate of abuse leads to an increased number of people who are physical dependent on or addiction to morphine and other opioids. About 2 million Americans are now dependent on opioids such as morphine and an ever-increasing number of people are becoming addicted to these powerful analgesics.

The Definition of Addiction

The American Society of Addiction Medicine, or ASAM, offers a detailed and complete definition of addiction. "Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors."

To put it another way, addiction is not the result of another disease or medical condition. Addiction is a long-term illness - recovery from morphine addiction may take several years of intense treatment. Opioid addiction changes the cells of the central nervous system, or CNS, in a way that affects the way the brain works. These neurological changes alter the way a person thinks, feels and acts.

A person who is addicted to morphine seem unwilling to unable to stop using this drug, even though he may express a desire to quit. He may have trouble controlling his behavior in other ways, participating in crimes or engaging in risky activities. He is unable to recognize serious problems in his life and relationships. He may have trouble making emotional connections to others. Without help, morphine addiction grows worse and can result in disability or premature death.

Addiction versus Dependence

Morphine use and abuse may lead to addiction, dependence, or both. While some use the words addiction and dependence interchangeably, these two conditions are separate and very different from one another.

The body adapts to the presence of foreign substances such as Morphine by adjusting its own chemical balance. With continued use, the body begins to depend on a certain level of Morphine to feel "normal." If the level of Morphine drops suddenly, the body struggles to maintain chemical balance. The individual feels unpleasant, flu-like withdrawal symptoms. Morphine withdrawal symptoms are similar to other opioids and include:

Abdominal Cramping

Diarrhea

Fever, Runny Nose or Sneezing

Goose Bumps and Abnormal Skin Sensations

Hot Sweats and Cold Sweats

Insomnia

Low Energy Level

Muscle Aches or Pains

Nausea or Vomiting

Pain

Rapid Heartbeat

Rigid Muscles

Runny Nose

Shivering, Tremors

Teary Eyes

Yawning

An individual dependent on opioids experiences physical withdrawal symptoms when she runs out of Morphine, while the addicted individual will express behavioral symptoms such as cravings and drug seeking.

Symptoms of morphine addiction include:

Inability to Consistently Abstain from Morphine

Behavioral Control Problems

Cravings for Morphine

Inability to Recognize Significant Problems with One's Own Behaviors and Interpersonal Relationships

Inappropriate Emotional Response

Someone can be addicted to a substance and not dependent upon it, and vice versa. For example, a person might be dependent on an anti-hypertensive; if he stops taking his medication, his blood pressure rises as his body fights to maintain chemical stability, but he will not feel cravings for the drug. Conversely, prolonged cocaine use may result in addictive behavior but not physical dependence - the individual will crave cocaine if he stops taking it, but he will not suffer flu-like withdrawal symptoms.

Addiction: What Family Members Should Know

Addiction is a disease that affects the central nervous system, like Alzheimer's or Huntington's disease. Morphine addiction is not an indication of poor child rearing or weak moral character. As with any chronic and life threatening medical condition, your family member needs your love and support now more than ever.

Family members should know that everyone in the immediate family shares a risk for developing an addiction. Scientists agree that heredity plays a role in the development of addiction to substances such as morphine. Researchers also know that stresses within the home environment raises everyone's risk for developing an addiction at some point.

Stress and Other Environmental Factors

A stressful home or work life increases the risk for addictive behaviors in everyone within the environment. Some researchers feel a hypersensitivity to stress increases the odds for developing an addiction; this hypersensitivity is often passed from one generation to the next. A hypersensitive individual may have also learned poor coping mechanisms from a parent.

Reducing environmental stress decreases the risk of addiction for each member of the family. A family member can learn to recognize and reduce household stress to help the addicted individual and to decrease his own risks for developing addiction.

Morphine addiction affects and endangers the entire family. Addiction inflicts collateral damage to a large radius surrounding the addicted person, including children, spouses, family members, friends and co-workers. Addiction diverts funds from groceries, rent and childcare towards the purchase of morphine. Children lose the guidance and support of a parent as she spends an ever-increasing amount of time and resources seeking morphine, getting high or recovering from the effects of morphine.

Morphine addiction prevents the employee from doing his job well on those days she is able to show up at all. The addicted individual associates with drug dealers, endangering the safety and well-being of everyone in her household. Her addiction to morphine may drive her to commit crimes. If she is arrested for illicit drug use, she will have to divert funds from the family towards her legal defense. Morphine addiction can also drive up medical costs, especially if she overdoses or becomes ill with a disease commonly associated with drug use.

Addiction: What Parents Should Know

Teenagers and young adults are abusing prescription painkillers more frequently now because these drugs are widely available. Teenagers get opioids such as Morphine free from the family medicine cabinet, from friends or relatives. Because they are legal, young people attach less of a social stigma to prescription opioids such as morphine than to marijuana or heroin.

Parents of teens or young adults should look for warning signs including:

Unusual loss of interest in things that once were important

Drop in academic performance

Loss of motivation or energy

Finds ways to sneak off

Money issues

Items missing from the home

Caring for a Family Member with an Addiction

Family members can create a supportive network to help the individual recover from his morphine addiction. Each member of the family participates according to his age and abilities. For example, a grandparent might take over some of the childcare, a younger child can do some light housework and an older child can run errands.

This type of teamwork can occur only after the family begins to communicate about morphine addiction. This communication can happen between just two or three individuals but it works best if the whole family is involved. Hold family meetings on a regular basis to discuss progress.

The addicted person does not have to participate at first; he may be reluctant to talk about his illness in the beginning. He might even angry when he learns the family wants to become involved in his addiction. This anger and resentment will fade as the addicted individual breaks free from the cycle of addiction.

Addiction causes plenty of collateral damage but recovery has a positive effect on a family. The challenge of morphine addiction and recovery tends to bring a family closer together. Working as a team, the family resolves any issues that put them all at risk for developing addictions.

The family unit plays a critical role in recovery from morphine addiction. Family members are frequently the first to encourage the addicted individual to seek and complete treatment for his morphine addiction. It is quite common for a family member to have chosen the treatment facility the addicted individual eventually attends.

The treatment and recovery experience works best when the individual feels physically, emotionally and spiritually safe in his home environment. Family members must recognize morphine addiction as a disease and work to avoid blaming the individual for his illness.

When to Suggest Treatment

It is possible to arrest the disease's progression at any time. As with many medical conditions, recovery from addiction may be easier with early treatment, before it can make lasting changes to the nervous system.

It is important to remember that a person does not have to hit rock bottom before seeking treatment. The rock bottom of morphine addiction could include a lengthy prison sentence, overdose, divorce, unemployment, homelessness or even death. These terrible consequences of morphine addiction put recovery even further out of reach.

Recovery often starts when the individual sees the problems her addiction causes. Sometimes, caring family members want to cushion their loved one from the consequences of addiction, enabling the addictive behaviors to continue. It is important to support the addicted individual without sheltering him.

Signs of Addiction

Morphine addiction alters the way someone thinks, feels and behaves. The cognitive, emotional and behavioral changes associated with morphine addiction vary between individuals.

Behavioral, Cognitive and Emotional Changes

Behavioral:

An addicted person uses morphine excessively, at higher doses and more often than he intends. He might say he wants to quit, even while taking more morphine. He may try to quit morphine several times but seem unwilling or unable to stop using morphine permanently.

Addiction causes the individual to lose a great deal of time looking for morphine, getting high or recovering from drug abuse. Morphine addiction has a profoundly negative impact on his ability to work or engage in normal relationships with a spouse, parent or child.

The addicted person continues to abuse morphine, despite the terrible toll on his health and family. With continued use, addiction changes the reward circuitry in the individual's brain; he loses interest in things he used to love. Soon, morphine is all he cares about.

Cognitive:

Addiction changes the way a person thinks. The morphine-addicted individual is preoccupied with morphine - it is all she can think of. Her view of morphine's relative benefits and risks shift so that she recognizes only the benefits of morphine and none of the harm. She may believe other people or situations have cause her problems rather than attributing them to her morphine addiction.

Emotional:

Morphine addiction changes the way a person feels. An addicted person often expresses increased anxiety, unhappiness and emotional pain. Morphine addiction often makes the world seem more stressful.

A person addicted to morphine or other opioids may have difficulty identifying or expressing his feelings. He may be unable to distinguish emotions from bodily sensations.

Symptoms of Addiction

Addiction manifests itself in a variety of physical and psychological symptoms. These symptoms can be obvious or subtle, and vary from person to person.

Physical Symptoms

While addiction is normally described as a behavioral problem, a person addicted to morphine does display certain physical symptoms. Physical symptoms of drug addiction include:

Unexplained Weight Gain or Weight Loss

A Change in Sleep Patterns

Deteriorating Physical Appearance - Looks Sickly

Nagging Cough

Diminished Hygiene Care

Body or Clothing May Have an Unusual Odor

Bloodshot Eyes with Large or Small Pupils

Tremors

Slurred Speech

Psychological Symptoms

The psychological symptoms of morphine addiction can be difficult to recognize because this disease often separates the addicted individual from those people who know him best.

Gender Differences

Males are twice as likely to abuse illicit drugs or be dependent on them, according to the 2010 National Survey on Drug Use and Health. In 2010, 5.9 percent of females reported using illicit drugs, as compared to 11.6 percent of males.

There was a slight decline in substance abuse from 2009, when 6.1 percent of females and 11.9 percent of males reported abuse or dependence.

While fewer women abuse illicit substances such cocaine or heroin, women are more likely to use prescription drugs non-medically. Females are also more apt to abuse multiple substances.

Studies suggest physicians prescribe mood-altering drugs more frequently to female alcoholics than to male alcoholics because the healthcare providers attribute the cause of the female's condition to be rooted in depression, anxiety or some other emotional difficulty. As a result, women are more likely to combine prescription psychoactive drugs, like morphine, with alcohol or illegal drugs.

Women seem to judge illegal drug use more harshly than males, and this social stigma deters many women from using illicit substances at the same rate as males. However, there is less of a stigma against prescription drug abuse.

Cause of Gender Differences

Female drug abusers tend to come from families where one or more family members were addicted to drugs or alcohol. Girls who carry too much responsibility in the home face an increased risk for developing an addiction later in life. Addicted women also report more family disruption when they were growing up than males do. Women with addictions tend to be in relationships with a partner who also has a substance abuse problem.

Women are more likely to name a relationship or traumatic event as the cause of addiction to substances such as morphine. Women seem more likely to blame drug abuse on genetics, family history or environmental stress than men do.

Females tend to have co-existing issues such as a poor body image, eating disorders and are more likely to have attempted suicide than men are. In general, addicted women have lower expectations for their lives, less education, fewer marketable skills and less job experience than males.

Women seek treatment more frequently than men do but females complete treatment less often. Females seem to face additional barriers to treatment, including financial hardship and social stigmas. Many women battling morphine addiction or other substance abuse problems have trouble finding someone to watch their children while they engage in rehabilitation.

Treatment Options

The American Society of Addictive Medicine warns that addiction to morphine or other substances may result in "disability or premature death, especially when left untreated or treated inadequately."

Treatment usually consists of two phases: detoxification and rehabilitation. Detoxification is the process of lowering opioids to non-toxic levels. An individual going through morphine detoxification typically experiences five or more days of intense physical withdrawal symptoms as his body adjusts to the lack of opioids.

The rehabilitation phase focuses on changing the cognitive and behavioral aspects of morphine addiction. This portion of treatment typically involves behavior modification techniques along with individual, group and family counseling to help the addicted individual learn how to live without morphine.

Detoxification

Some addicted individuals attempt self-detoxification to free themselves from morphine addiction. Self-detoxification is the process of going through withdrawal alone, without the help of trained professionals or medicines to ease physical and psychological symptoms. Profoundly strong withdrawal symptoms often drive these addicted individuals back to morphine use.

Some develop a homemade treatment plan to ease the detoxification process. One such home remedy is the Thomas Recipe, in which individuals use medicine such as Xanax to ease anxiety, anti-diarrhea medications, vitamins and hot baths to reduce withdrawal symptoms.

Detoxification takes five or more days, with the worst symptoms occurring on or about the fourth day. While the Thomas Recipe relieves the physical symptoms associated with morphine detoxification, it does not address the psychological symptoms that cause many people to relapse.

Overdose

The biggest risk to recovery is relapse, potentially leading to fatal overdose. Detoxification reduces tolerance to opioids; there is a greater risk for overdose immediately following an attempted detoxification. A person can potentially overdose on a lesser dose of morphine than he used to take before going through withdrawal.

Overdose is a serious, life threatening medical emergency. If you think you or someone you know has overdosed on morphine or any other medication, contact poison control center at 1-800-222-1222 or go to the nearest hospital.

Overdose symptoms include:

Extreme Drowsiness

Pinpoint Pupils

Nausea

Vomiting

Diarrhea

Confusion

Ringing in the Ears

Cold, Clammy Skin

Muscle Weakness

Fainting

Weak Pulse

Slow Heart Rate

Coma

Blue Lips

Shallow Breathing or No Breathing

While the patient is in the emergency department, doctors and nurses administer naloxone or other drugs to drop morphine to non-toxic levels quickly. Nurses will establish an airway to help the patient breathe, start intravenous fluids and pump excess morphine from the stomach. They will also perform other emergency, life-saving treatments such as CPR as necessary to save the patient's life.

Once the individual is out of mortal danger, he can participate in behavior modification to learn how to live without morphine.

Drug Replacement Therapy

No one should wait for an overdose or other serious consequence of morphine addiction before taking action. An addicted individual in otherwise good health may choose to participate in drug replacement therapy, known as DRT, which allows her to temporarily skip the withdrawal symptoms and move directly into therapy. Methadone, buprenorphine and Suboxone are different types of DRT.

Replacement drugs reduce the withdrawal symptoms associated with morphine but do not get the individual high. This allows some people to put off the detoxification process for a little while and start with behavior modification therapy.

After the individual changes the behaviors associated with addiction, he weans himself from the replacement drug. Harvard Medical School cites estimates that 25 percent of methadone DRT patients eventually abstain, another 25 percent continues to take the drug and 50 percent go on and off methadone.

DRT is just one type of Medically-Assisted Treatment, or MAT, in which physicians administer drugs to lower opioid levels in the body and reduce withdrawal symptoms. Standard detoxification and rapid detox are other types of MAT. Research shows MAT has many benefits, such as:

Improved Survival Rates

Increased Retention in Treatment

Decreased Illicit Opioid Use

Decreased Risk for Hepatitis and HIV

Decreased Criminal Activities

Increased Employment

Improved Birth Outcomes for Pregnant Women Battling Addiction

Standard detoxification is another type of MAT in which doctors administer naloxone to lower opioid levels along with other medications to reduce withdrawal symptoms. While inpatient standard detoxification reduces severity and duration of withdrawal symptoms a bit, the patient must still suffer the demoralizing and debilitating psychological symptoms that usually accompany detoxification. Furthermore, standard detoxification requires a lengthy stay in a hospital.

Rapid Detox is the most humane and efficient way to cleanse morphine from the body. During rapid detox, board certified anesthesiologists administer sedatives and anesthesia along with the typical detoxification drugs. The patient rests in a comfortable "twilight sleep" and awakens refreshed, unaffected by psychological withdrawal symptoms and unaware of the grueling detoxification process.

Rehabilitation

Successful recovery from morphine often includes rehabilitation and behavior modification. While morphine addiction is complex disease that affects brain function and behavior, it is treatable with prompt and appropriate care. Individual, family and group counseling, along with other behavioral therapy, are the most commonly used forms of drug abuse treatment. While no single treatment works for everyone, treatment does needs to be readily available to be effective.

Healthcare professionals should perform an initial assessment for the presence of HIV/ AIDS, hepatitis B and C, tuberculosis, and other infectious diseases. Therapists then help patients modify or change behaviors that place them at risk of contracting or spreading infectious diseases.

The most effective treatment must attend to the complex and multiple needs of the individual, and not just focus on his morphine abuse. Many drug-addicted individuals also have other mental disorders that impede recovery.

Medication is an important element of treatment for many patients, especially when therapists combine MAT with counseling and other behavioral therapies. Medically assisted detoxification is only the first stage of treatment for morphine treatment and, by itself, does little to change long-term drug abuse.

The individual must remain in treatment for an adequate amount of time for the treatment to be effective. Counselors and physicians should continually assess and modify the individual's treatment plan. Rehabilitation specialists must continually monitor a patient for drug use during treatment, as lapses during treatment do occur.

Treatment for addiction to opioids such as morphine does not need to be voluntary to be effective. According to NIDA, those under legal coercion tend to remain in treatment longer than and do better than those not under pressure. Not surprisingly, people would rather stay in drug rehabilitation units than go to jail.